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https://doi.org/10.1007/s00520-021-06430-3
ORIGINAL ARTICLE
Communicating cancer andits treatment toAustralian Aboriginal
andTorres Strait Islander patients withcancer: aqualitative study
IanOlver1 · KateM.Gunn2· AlwinChong3· VikkiKnott4· KristiaanSpronk2· NayiaCominos5· JoanCunningham6
Received: 14 March 2021 / Accepted: 11 July 2021
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021
Abstract
Purpose To investigate the successful strategies of health workers who support and regularly communicate with Aboriginal
and Torres Strait Islander people about cancer and its treatment.
Methods Semi-structured interviews were conducted face-to face or via telephone and audio-recorded with twenty-three
health professionals (medical and radiation oncologists, oncology nurses and Aboriginal Health Workers), 5 identifying
as Aboriginal or Torres Strait Islander in the Northern Territory and South Australia. When data saturation was reached,
thematic analysis using a bottom up, essentialist/realist approach was used.
Results Six themes emerged. (1) Create a safe environment, engender trust and build rapport. This involves considering the
physical environment and allowing time in interviews to establish a relationship. (2) Employ specific communication strate-
gies to explain cancer, treatment and its side effects through language choices and employing visual aids such as drawings,
metaphors and relatable analogies. (3) Obtain support from Aboriginal and Torres Strait Islander staff and patient escorts
who can assist in communication. (4) Consider culture which involves collective decision making, strong connection to
country and community, with cultural obligations and a unique understanding of cancer. (5) Anticipate the contextual com-
plexities of conflicts between Western medicine and Aboriginal culture, practitioner bias and difficulty maintaining contact
with patients. (6) Develop personal qualities of good communicators, including being patient-centred, showing respect,
patience, empathy and honesty.
Conclusion These insights will help foster more positive interactions with the health system and promote optimal outcomes
for Aboriginal and Torres Strait Islander people with cancer.
Keywords Cancer· Communication· Aboriginal and Torres Strait Islander· Qualitative· Patient education
Introduction
There are known disparities in cancer outcomes between
Aboriginal and Torres Strait Islander and non-Aboriginal
Australians, with a 5-year survival rate of 48% compared to
59% [1]. To help address this, Cancer Australia developed
an optimal care pathway for Aboriginal and Torres Strait
Islander people in consultation with their community, with
communication identified as a principal component needed
to improve care and outcomes [2].
The authors argue that appropriate communication
will assist Aboriginal and Torres Strait Islander people to
respond more effectively to a disease with a stigma that in
the past has had a negative effect on individuals’ uptake of
clinical care in a timely manner.
Barriers to Aboriginal and Torres Strait Islander peo-
ple engaging in cancer treatment vary, but may include
* Ian Olver
ian.olver@adelaide.edu.au
1 School ofPsychology, Faculty ofHealth andMedical
Sciences, The University ofAdelaide, Adelaide, Australia
2 Department ofRural Health, Allied Health andHuman
Performance, University ofSouth Australia, Adelaide,
Australia
3 Division ofHealth Sciences, University ofSouth Australia,
Adelaide, Australia
4 Psychological Sciences, Australian College ofApplied
Psychology, Brisbane, Australia
5 Prideaux Health Professions Education, College ofMedicine
andPublic Health, Flinders University, Adelaide, Australia
6 Menzies School ofHealth Research, Charles Darwin
University, Darwin, NT, Australia
/ Published online: 24 July 2021
Supportive Care in Cancer (2022) 30:431–438
Content courtesy of Springer Nature, terms of use apply. Rights reserved.